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Appendix XI – EASA Form 65 – Letter of Agreement for production without a production organisation approval

Regulation (EU) 2022/201

Appendix XI

 

Letter of agreement for production without a production organisation approval — EASA Form 65

 

Letter of agreement referred to in Subpart F of Annex I (Part 21)

[MEMBER STATE][64]

A Member of the European Union[65]

 

LETTER OF AGREEMENT FOR PRODUCTION WITHOUT PRODUCTION ORGANISATION APPROVAL

 

[NAME OF THE APPLICANT]

[TRADE NAME (if different from the name of the applicant)]

[FULL POSTAL ADDRESS OF THE APPLICANT]

Date (Day, Month, Year)

Reference: [MEMBER STATE CODE[66]].21F.XXXX

 

Dear Mr/Ms [Name of the Applicant],

Your production inspection system has been evaluated and found to be in compliance with Section A, Subpart A and Subpart F of Annex I (Part 21) to Commission Regulation (EU) No 748/2012.

 

Therefore, subject to the conditions specified below, we agree that the showing of conformity of the products, parts and appliances mentioned below may be done under Section A, Subpart F of Annex I (Part 21) to Regulation (EU) No 748/2012.

 

         No of Units           P/N             S/N

 

AIRCRAFT

PARTS

The following conditions are applicable to this letter of agreement:

(1)     It is valid while [Company Name] remains in compliance with Section A, Subpart A and Subpart F of Annex I (Part 21) to Regulation (EU) No 748/2012.

(2)     It requires compliance with the procedures specified in [Company Name] manual ref./issue date........................

(3)     It terminates on ……………………………..

(4)     The statement of conformity issued by [Company Name] under point 21.A.130 of Regulation (EU) No 748/2012 shall be validated by the issuing authority of this letter of agreement in accordance with the procedure................ of the referenced manual.

(5)     [Company Name] shall notify the issuing authority of this letter of agreement immediately of any changes to the production inspection system that may affect the inspection, conformity or airworthiness of the products and parts listed in this letter.

For the competent authority: [COMPETENT AUTHORITY IDENTIFICATION[67] [68]]

Date and Signature

EASA Form 65 – Issue 3


[65]           Delete for non-EU Member States.

[66]           Delete for non-EU Member States.

[67]           Or “EASA”, if EASA is the competent authority.

[68]           Delete for non-EU Member States.